| NPI | 1043707110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U1931) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX U1931) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2025-11-18 |